Is there a list of important questions to ask your surgeon?
Good morning…
I am newly diagnosed and looking for anyone who can offer me insight on my upcoming initial meeting with the surgeon. Are there important questions to ask that I might overlook? I feel like I have been sucked into a funnel that's spinning. I am just trying to get my bearings here. But I feel more solid every single day that a new piece of information reveals itself. I am struck by the incredible knowledge of this group of wonderful women and thank you for your embrace.
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From this web site:
Your Diagnosis: Questions to Ask Your Doctor
Last modified on March 25, 2014 at 11:48 AM
- Is this breast cancer invasive, non-invasive, or both invasive and non-invasive?
- Is the breast cancer more aggressive or less aggressive?
- Are the surgical margins negative, close, or positive? If negative, how wide were they?
- Are there any cancer cells present in lymph channels or blood vessels?
- What do the hormone receptor tests show? Am I a candidate for medicine that lowers or blocks the effects of estrogen?
- Which of these HER2 tests was performed on the tissue?
- IHC (ImmunoHistoChemistry) test
- FISH (Fluorescence In Situ Hybridization) test
- SPoT-Light HER2 CISH (Subtraction Probe Technology Chromogenic In Situ Hybridization) test
- Inform HER2 Dual ISH (Inform Dual In Situ Hybridization) test
- Is the HER2 test positive, negative, or borderline? Am I a candidate for HER2-targeted therapy?
- Is there cancer in any lymph nodes? If so, how many lymph nodes are involved?
- Am I eligible for a genomic assay such as Oncotype DX, MammaPrint, or Mammostrat?
- If any of my test results were unclear, would you recommend testing the tissue again?
- Is any further surgery recommended based on my results?
- Which treatments are most likely to work for this specific cancer, based on my pathology report results?
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This list of questions is general and some of them I might not ask a surgeon, but rather an oncologist - mainly the ones about systemic therapy such as hormonal therapy, and treatments based on the pathology report. This information is not necessarily in the purview of the surgeon, particularly if you are using a general surgeon and not an oncological breast surgeon. I would definitely ask about any pre-surgical testing that needs to be done, such as an MRI if you have not already had one. I would ask about surgery types and reconstruction choices and for a consult with a plastic surgeon who has worked with your surgeon if you desire or need reconstruction at the time of breast surgery. Ask what is a normal time lag for scheduling your type of surgery choice - which can be a number of weeks or months depending on what you choose and whether you need a simultaneous plastic surgeon. Also important to keep in mind that customs and practices vary among surgeons, so if you read something different from what your docs say, don't be alarmed.
Here are some links from the Surgery thread:
http://community.breastcancer.org/forum/91/topic/699896?page=22#idx_631
http://community.breastcancer.org/forum/91/topic/773030?page=1#idx_1
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If you are thinking reconstruction at the time of surgery, you may want to ask if performing the sentinel lymph node biopsy ahead of the breast surgery is an option. My surgeon performed the lymph node biopsy about 2 weeks before my surgery because he knew I wanted to have reconstruction only if it could be done at the same time as my bilateral mastectomy. And if radiation was in my future, meaning if the biopsy was positive for lymph node involvement, then I would not be a good candidate for reconstruction at the time of surgery.
Just something to consider.....as if you didn't have enough to think about.
Good luck! I am sure you have heard it before, but the final pathology report will provide the true staging and a lot more information that the initial diagnosis.
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goodnessme, there are other lists on the main Breastcancer.org site that are specifically aimed at meetings with a surgeon. Starting from this link of search results, you can read the separate Questions to Ask Your Surgeon lists about Mastectomy, Reconstruction, Lumpectomy and Lymph Node Removal, as well as a general list about Surgery.
Best wishes,
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